oru.sePublikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Nurses’ and physicians’ opinions on aggressiveness of treatment for general ward patients
Örebro universitet, Institutionen för klinisk medicin.ORCID-id: 0000-0003-0679-5695
Örebro universitet, Hälsovetenskapliga institutionen.
2006 (Engelska)Ingår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 13, nr 2, s. 147-162Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The aim of this study was to evaluate agreement between nurses’ and physicians’ opinions regarding aggressiveness of treatment and to investigate and compare the rationales on which their opinions were based. Structured interviews regarding 714 patients were performed on seven general wards of a university hospital. The data gathered were then subjected to qualitative and quantitative analyses. There was 86% agreement between nurses’ and physicians’ opinions regarding full or limited treatment when the answers given as ‘uncertain’ were excluded. Agreement was less (77%) for patients with a life expectancy of less than one year. Disagreements were not associated with professional status because the physicians considered limiting life-sustaining treatment as often as the nurses. A broad spectrum of rationales was given but the results focus mostly on those for full treatment. The nurses and the physicians had similar bases for their opinions. For the majority of the patients, medical rationales were used, but age and quality of life were also expressed as important determinants. When considering full treatment, nurses used quality-of-life rationales for significantly more patients than the physicians. Respect for patients’ wishes had a minor influence.

Ort, förlag, år, upplaga, sidor
2006. Vol. 13, nr 2, s. 147-162
Nationell ämneskategori
Tvärvetenskapliga studier inom samhällsvetenskap Omvårdnad Humaniora och konst Religionsvetenskap
Forskningsämne
Vårdvetenskap
Identifikatorer
URN: urn:nbn:se:oru:diva-2975DOI: 10.1191/0969733006ne861oaOAI: oai:DiVA.org:oru-2975DiVA, id: diva2:135873
Tillgänglig från: 2008-04-22 Skapad: 2008-04-22 Senast uppdaterad: 2018-01-13Bibliografiskt granskad
Ingår i avhandling
1. Postpone death?: Nurse-physician perspectives on life-sustaining treatment and ethics rounds
Öppna denna publikation i ny flik eller fönster >>Postpone death?: Nurse-physician perspectives on life-sustaining treatment and ethics rounds
2008 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

The starting point of the present thesis is nurses’ reported experiences of disagreements with physicians for pushing life sustaining treatment too far. The overall aim was to describe and compare nurses’ and physicians’ perspectives on the boundaries for life-sustaining treatment and to evaluate whether ethics rounds could promote mutual understanding and stimulate ethical reflection. A mixed methods design with qualitative and quantitative data was used, including interviews and questionnaires. The health professionals’ experiences/perceptions were based on known patients foremost from general wards, but also intensive care units, at four Swedish hospitals. The first two studies treated the perspective on boundaries for life-sustaining treatment and the last two evaluated philosopher- ethicist led ethics rounds. Analysis of data was performed using a phenomenological approach and content analysis as well as comparative and descriptive non-parametric statistics.

In the first study, the essence of the physicians’ decision-making process to limit life-sustaining treatment for ICU patients, was a process of principally medical considerations in discussions with other physicians. In the second study, there were more similarities than differences between nurses’ and physicians’ opinions regarding the 714 patients studied. The physicians considered limited treatment as often as the nurses did. The ethics rounds studies generated mixed experiences/perceptions. It seemed that more progress was made toward the goal of promoting mutual understanding than toward the goal of stimulating ethical reflection. Above all, the rounds seemed to meet the need for a forum for crossing over professional boundaries. The most salient finding was the insight to enhance team collaboration, that the interprofessional dialogue was sure to continue. Predominating new insights after rounds were interpreted as corresponding to a hermeneutic approach. One of nurses’ negative experiences of the ethics rounds was associated with the lack of solutions. Based on the present findings, one suggestion for improvement of the model of ethics rounds is made with regard to achieving a balance between ethical analyses, conflict resolution and problem solving. In conclusion, the present thesis provides strong evidence that differences in opinions regarding boundaries for life-sustaining treatment are not associated with professional status. The findings support the notion of a collaborative team approach to end-of-life decision-making for patients with diminished decisionmaking capacity. There is an indication that stimulation of ethical reflection in relation to known patients may foremost yield psychosocial insights. This could imply that social conflicts may overshadow ethical analysis or that ethical conflicts and social conflicts are impossible to distinguish.

Ort, förlag, år, upplaga, sidor
Örebro: Örebro universitet, 2008. s. 73
Serie
Örebro Studies in Medicine, ISSN 1652-4063 ; 16
Nyckelord
Clinical ethics, Life-sustaining treatment, End-of-life decisions, Attitudes, Nurses, Physicians, Inter-professional relations, Ethics consultation, Ethics rounds
Nationell ämneskategori
Klinisk vetenskap
Forskningsämne
Kirurgi
Identifikatorer
urn:nbn:se:oru:diva-2093 (URN)978-91-7668-596-9 (ISBN)
Disputation
2008-05-16, Wilandersalen, M-huset, Universitetssjukhuset, Örebro, 13:00 (Engelska)
Opponent
Handledare
Tillgänglig från: 2008-04-22 Skapad: 2008-04-22 Senast uppdaterad: 2017-10-18Bibliografiskt granskad

Open Access i DiVA

Fulltext saknas i DiVA

Övriga länkar

Förlagets fulltext

Personposter BETA

Svantesson, MiaThorsén, Håkan

Sök vidare i DiVA

Av författaren/redaktören
Svantesson, MiaThorsén, Håkan
Av organisationen
Institutionen för klinisk medicinHälsovetenskapliga institutionen
I samma tidskrift
Nursing Ethics
Tvärvetenskapliga studier inom samhällsvetenskapOmvårdnadHumaniora och konstReligionsvetenskap

Sök vidare utanför DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetricpoäng

doi
urn-nbn
Totalt: 92 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf